The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. The Care Manager, Telephonic Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.
The Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder effective care. Ensures patient is progressing towards desired outcomes by continuously monitoring patient care through assessments and/or evaluations. May create member care plans. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.
The HumanaBeginnings (HB) Prenatal Care Manager, Telephonic Nurse 2 engages with pregnant members to provide education and resources on pregnancy, pregnancy-associated conditions, and chronic health conditions affecting pregnancy to achieve the best possible birth outcome. The HB Care Manager provides a point of contact within the health plan for pregnant members and assists members with obtaining information, tools and resources so the member can make informed decisions about her health as well as her family’s for life long well-being.
Reports directly to HumanaBeginnings Telephonic Care Nursing Manager.
Engages Humana’s members in a relationship focused on the health concerns of the members with specific attention to health decisions (choices) and health behaviors (changes). This is done through outbound and inbound telephone calls.
Facilitates and encourages members’ capacities and desire to learn about their own health needs in collaboration with their providers through focused exploration and education.
Guides members to information and resources on health conditions, treatment options, and preventative services related to pregnancy and general physical, mental, and dental health.
Provides a point of contact within the health plan for members with pregnancy/post-partum related needs.
Participates in HumanaBeginnings program development through voluntary participation in various committees and forums.
Documents all member contacts and activity within the Humana Systems.
Tracks daily, weekly, and monthly activity in order to accomplish targeted program and individual goals for performance.
Engage in ongoing continuing education in order to maintain and improve nursing knowledge related to pregnancy, childbirth, the postpartum period and childcare.
3-5 years of clinical maternal-child health nursing experience
Active RN license in the state of residence and have the ability to be to be licensed in multiple states without restrictions
Comprehensive knowledge of Microsoft Office applications including Word, Excel, and Outlook
Must have a separate room with a locked door that can be used as a home office to ensure you and your member’s have absolute and continuous privacy while you work
Must provide a high speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role) A minimum standard speed for optimal performance of 10x1 (10mbs download x 1mbs upload) is required
Previous health plan experience
Prior experience in a work at home and telephonic role
Scheduled Weekly Hours
Equal Opportunity Employer
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